Question 1:
Several legal and ethical principles influence the workforce in healthcare organizations, particularly in light of employees belonging to diverse cultural backgrounds coming together for achieving common organizational goals. Towards managing employees in a huge healthcare setting it would be effective for HR functionaries to understand the legal relationships existing between the organization and employees in the first place. Most importantly, healthcare organizations that employ diverse employees must clearly define ethical behavior patterns of employees among each other and with the patients and their family members. Ethical behavior with employees belonging to another culture calls for not only treating each other in ways as demanded by law, but doing the right things that are ethically acceptable to everyone, regardless of one’s cultural or ethnic background. To begin with, organizations must define ethical behavior in the workplace to effectively select and retain diverse employees. Monthly debriefing sessions involving employees across all levels to sort out issues pertaining to different ethical dilemmas help healthcare organizations to effectively manage diverse workforce (Reed, 2011). Effective recruitment and retention of diverse employees in healthcare organizations depends on how organizations learn to appreciate and react effectively to the needs, values and beliefs diverse employees bring to the organizations. In other words, addressing diversity ramifications in healthcare settings involves correcting popular misconceptions with respect to the difference that exists among individual employees or groups and discovering the most effective means of utilizing the skills of diverse employees.
Employees in a multicultural healthcare organization are driven by popular stereotypes and prejudices about other cultures that continue to act as barriers to effective communication. One of the most hazardous ramifications of multicultural workplace in healthcare is mistrust. Even though mistrust towards another culture can be generated among employees in many ways during encounters in the workplace, the most common way it is generated is through fear that stems from harmful treatment based on a person’s ethnicity or race. Also, treating a particular ethnic group unfairly in the workplace would deter individuals from that particular group from embracing healthcare as a profession that ultimately leads to health disparity. This in future would lead to the discriminated community not having adequate healthcare professionals in tune with the changing demographics, which in turn affects the healthcare access as well as outcomes of patients belonging to the particular disadvantageous group. The cultural background of employees in a healthcare organization is likely to influence the way they interpret various illnesses or disabilities; therefore, organizations are challenged to provide standardized healthcare to the population. Furthermore, failure to implement appropriate cultural diversity management programs in the healthcare workplace prevents employees from sharing common vision and values that in due course leads to poor quality of service.
Imparting cultural sensitivity and diversity training to employees gives them a higher awareness and knowledge relating to culture, ethnicity, gender, towards understanding the behaviors of individuals in the organization. Organizations can promote social gatherings periodically wherein individuals belonging to various cultural backgrounds assemble with family members to share their beliefs and values and understand each other. The low income and minority groups in the U.S are reported to have only suboptimal access to quality healthcare (Disparities in Healthcare Quality among Racial and Ethnic Minority Groups, 2014). A policy of hiring diversity candidates and implementing diversity training and mentoring programs will help eliminate health disparities in future. In light of predictions that say the current minority population would comprise of 50 percent of U.S. population by the year 2050, healthcare organizations can ensure a diverse culture by promoting minorities in the workplace through implementing effective minority programs towards enhancing the competencies of the minorities on par with the majority groups.
Question 2:
It is critical that employees with various professional commitments and competencies in healthcare organizations tune their efforts in keeping with the mission and values of the organization, particularly in a patient-centered care scenario. First and foremost, organizations have to clarify the vision, mission and values that are common to all, regardless of the position or professional commitments of employees within the organization. This makes their efforts go together with that of the other colleagues towards effectively achieving the common organizational goals. In brief, the control measures healthcare organizations need to have in place towards ensuring quality patient outcomes focus on effective team management. Healthcare teams comprise of multidisciplinary professionals with various competency levels. For instance, a healthcare team may comprises of a trainee nursing practitioner, a pharmacist with a few years of experience and a highly experienced medical specialist doctor with varied interests and proficiency levels. However, individuals in the team cannot have diverse objectives or goals apart from the common organizational goal. Therefore, identifying current competency levels and strengthening core competencies of employees within the teams to reach the expected proficiency level for achieving the current organizational objectives is the foundation for placing an effective control system (Inter-professional Education Collaborative Expert Panel, 2011).
Furthermore, it is important to incorporate into the control system a coordinated effort to embed essential knowledge to all the employees with diverse professional backgrounds with appropriate assessment strategies. Also, acknowledging the efforts of people playing various roles from time to time keeps them motivated and gives the confidence to move forward as a team with the common mission of providing impeccable patient-centered care. Wherever applicable, promoting inter-professionalism that calls for consistent demonstration of the core values of the organization in addition to applying the principles of ethics, empathy, unconditional care and interpersonal communication can help organizations provide faultless patient-centered care. It is quite common that in healthcare organizations providing multispecialty care, certain individuals repeatedly attract the attention of everyone, say a surgeon performing a rare surgery. This makes others feel that their contributions are insignificant. To avoid such beliefs discouraging other professionals with varying levels of competency, it is essential to clarify the multidisciplinary nature of healthcare profession to individuals across all levels in the organization so that the collective commitment and effort of individuals leads to achievement of the organizational goal. In other words, providing exemplary patient-centered care depends upon the ability of doctors, nurses, technicians and other individuals of various natures working in a healthcare organization to come together through effective communication and sharing their skills. Last but not the least the control measure should monitor the good relationship and exchange of information and inter-professional moral considerations between individuals with different professional commitments on a regular basis.
Question 3:
Recurring incidents of medical errors that are more often preventable made me to think about implementing a new system that maintains medical records electronically in my healthcare organization. The new system is a computerized one that gathers, stores and displays the information pertaining to patients. I also see many potential barriers to implement the new electronic system of data keeping. The most common barriers are; the technology being a new one makes the adoption little slow, and the poor change management system currently prevailing in the organization. I believe Kotter’s management theory on change readily applies to the change I envisage for my organization now. As Kotter points out, I am sure a clear vision to implement this change through enabling the board of directors and the senior management to direct, line up and inspire actions on the responsible team will help the new changes to bring more effectiveness to the organization in managing record keeping effectively (Kotter, 2012). Applying Kotter’s change management theory, I see the change process in three main phases.
The first phase involves creating a favorable environment for change that includes Kotter’s first three steps: creating urgency, forming a coalition and creating a clear vision. Here, creating the need for urgency is easier as the employees, both medical and non-medical, are already aware of the poor record keeping system that currently creates difficulties to the patients. Also a guiding coalition has to be established by presenting the problem and the proposed electronic system of record keeping to the senior management and the board of directors. Similarly, a clear vision and strategy can be developed that reflects the intended outcome of introducing the change that can be measurable to all the stakeholders concerned (Clarke, 2010).
The second phase comprises of Kotter’s steps of communicating the vision, overcoming possible obstacles and creating short-term gains. Communicating the vision is about clearly informing everyone about the new vision, including the patients, after the vision is agreed upon by all stakeholders concerned. Employees will continue to hear the same message from different departments to encourage buy-in by all stakeholders. Employees can work together towards removing the obstacles by convincing each other about the advantages of a new electronic record keeping system. Besides, everyone in the workplace can contribute to short term gains by testing the electronic system on a pilot basis or by sharing success stories on the use of electronic record keeping system in other organizations. Analysis of the advantages and disadvantages in each gain is also important for effecting suitable changes in the proposed system.
The last phase consists of Kotter’s seventh and eighth steps: consolidating the changes for future gains and making the change part of the organizational culture. I will make sure to announce victory slowly as premature announcement would lead to complacency. More importantly, incorporating the success firmly into the organizational culture warrants continuous monitoring of employees apart from motivating them to embrace the new culture, instead of slipping back into the older one.
References
Clark, C. (2010). From incivility to civility: Transforming the culture. Reflections on Nursing Leadership, 36(3).
Disparities in Healthcare Quality among Racial and Ethnic Minority Groups (2014). U.S. Department of health and human services. Retrieved from http:// archive. ahrq.gov/research/findings/nhqrdr/nhqrdr10/minority.html
Interprofessional Education Collaborative Expert Panel. (2011). Core competencies for interprofessional collaborative practice: Report of an expert panel. Washington, D.C.: Interprofessional Education Collaborative.
Kotter, J.P. (2012). Leading change. Cambridge: Harvard business
Reed, J.R. (2011). A Review of Ethics for the Radiologic Technologist. Radiologic Technology,82 (6), 519 – 539.
